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Classification of communication disabilities in children: contribution of the International Classification on Functioning, Disability and Health.

Problems in communication serve as frequent markers of developmental delay and disability in childhood. Documentation of delayed or atypical receptive or expressive communication is one of the key diagnostic factors in the identification of children for intervention and support. This paper (1) reviews issues in classification and measurement of communication disabilities, (2) presents an overview of the development and publication of the WHO International Classification of Functioning, Disability and Health (ICF), and (3) identifies the implications of the ICF for children and youths with communication disabilities. As a conceptual framework, the ICF may be used productively to define the focus for different efforts to address children's language and communication difficulties. Impairments of a physical or mental nature can be covered in the Body Function and Body Structure components, complementing the information provided by the ICD-10 with descriptive documentation. The component of Activities, encompassing performance aspects of communication, lends itself to functional assessment and intervention in habilitation and education programs. The component of Participation provides an operational basis for policy initiatives focusing on social integration and community life Finally, the Environmental Factors component serves as a framework for identifying the nature and extent of access and opportunity for individuals and populations.

Activities of Daily Living↗

HVC ridge deficiency classification: a therapeutically oriented classification.

Alveolar ridge defects resulting from tooth extraction, trauma, or periodontal disease often require surgical correction prior to prosthodontic reconstruction. Whether implants or conventional fixed prostheses are planned, without careful consideration and proper treatment planning, hard and/or soft tissue defects may lead to functional, structural, or esthetic compromises in the final prosthesis. This article reviews the etiology and treatment of alveolar ridge defects and introduces a therapeutically oriented classification system of such defects (horizontal, vertical, and combination-HVC-classification). In addition, a decision-making guide for approaching each defect type will be discussed, and clinical examples of treated cases will be presented.

Alveolar Bone Loss↗

Gene expression-based classification of malignant gliomas correlates better with survival than histological classification.

In modern clinical neuro-oncology, histopathological diagnosis affects therapeutic decisions and prognostic estimation more than any other variable. Among high-grade gliomas, histologically classic glioblastomas and anaplastic oligodendrogliomas follow markedly different clinical courses. Unfortunately, many malignant gliomas are diagnostically challenging; these nonclassic lesions are difficult to classify by histological features, generating considerable interobserver variability and limited diagnostic reproducibility. The resulting tentative pathological diagnoses create significant clinical confusion. We investigated whether gene expression profiling, coupled with class prediction methodology, could be used to classify high-grade gliomas in a manner more objective, explicit, and consistent than standard pathology. Microarray analysis was used to determine the expression of approximately 12000 genes in a set of 50 gliomas, 28 glioblastomas and 22 anaplastic oligodendrogliomas. Supervised learning approaches were used to build a two-class prediction model based on a subset of 14 glioblastomas and 7 anaplastic oligodendrogliomas with classic histology. A 20-feature k-nearest neighbor model correctly classified 18 of the 21 classic cases in leave-one-out cross-validation when compared with pathological diagnoses. This model was then used to predict the classification of clinically common, histologically nonclassic samples. When tumors were classified according to pathology, the survival of patients with nonclassic glioblastoma and nonclassic anaplastic oligodendroglioma was not significantly different (P = 0.19). However, class distinctions according to the model were significantly associated with survival outcome (P = 0.05). This class prediction model was capable of classifying high-grade, nonclassic glial tumors objectively and reproducibly. Moreover, the model provided a more accurate predictor of prognosis in these nonclassic lesions than did pathological classification. These data suggest that class prediction models, based on defined molecular profiles, classify diagnostically challenging malignant gliomas in a manner that better correlates with clinical outcome than does standard pathology.

Brain Neoplasms↗

[Classification of drugs using the ATC system (Anatomic, Therapeutic, Chemical Classification) and the latest changes].

World Health Organization (WHO) established ATC system of drug classification. All drugs are grouped in five levels (anatomical main group, therapeutic subgroup, pharmacological subgroup, chemical subgroup and chemical substance). Alterations in ATC classification are made only by experts in WHO centre in Oslo, Norway. Changes are made in assigned new international generic names (INN), in ATC levels likes in changes of Defined Daily Doses (DDD) once a year. Changes are made following current scientific articles and international pharmacopeas, as well as the guideline.

Pharmaceutical Preparations↗

[Changes in the pleura of subjects occupationally-exposed to asbestos: radiological study technique, spectrum, etiological classification and coding according to the ILO classification].

Pleural abnormalities of 119 occupationally asbestos-exposed with prominent internal stripe of the lateral thoracic wall were radiodiagnostically analysed by plain films of the thorax in four views and by computed tomography in the course of medical expert's certification. Abnormalities were coded according to 1980 ILO international classification of pneumoconioses. Hardly half of the patients had pleural abnormalities caused by asbestos exposure: Pleural plaques, "diffuse" pleural fibrosis, pleural effusions, organized pleural effusions and pleural tumors. The other half of the patients had pleural involvement of pulmonary and chest wall abnormalities or variations of the lateral thoracic wall not related to asbestos exposure. The 1980 ILO classification of pneumoconioses proved to be inadequate for complete coding of the abnormalities, since only the postero-anterior plain film of the thorax must be used, since the normal appearance of the pleura is insufficiently defined and since the entity of organized pleural effusion is lacking.

Asbestosis↗

Visual classification of banded human chromosomes. III. Classification and karyotyping of density profiles described by band transition sequences.

Band transition profiles (BT-profiles) representing extracted band pattern features of 898 density profiles of banded chromosomes were classified and karyotyped by a cytogeneticist in order to investigate how much information was lost by substituting for the original density profiles their extracted features. The results were evaluated and compared with visual classification and karyotyping of the same 898 density profiles from which the BT-profiles were derived. Six per cent errors were made in classification of isolated BT-profiles and 0.7% errors were made in karyotyping BT-profiles. These error rates were comparable to the corresponding error rates in classifying and karyotyping density profiles, which were 5% and 0.5%, respectively. It is concluded that most of the important band pattern information of the density profiles is retained in the BT-profiles, and it is supposed that the condensed BT-sequences (from which the BT-profiles are derived) constitute a sufficient and appropriate basis for automated karyotyping.

Chromosome Banding↗

A clinical statistical study of lung cancer patients in Japan with special reference to the staging system of TNM classification: a report from the Japan Joint Committee of Lung Cancer associated with the TNM System of Clinical Classification (UICC).

In 1978, after having conducted clinical field trials, the TNM Committee of Union Internationale Contre le Cancer (UICC) decided on an uniform system for the classification of lung cancer. The Japan Joint Committee of Lung Cancer (JCC) has continued to conduct field studies recommended by UICC, and since then has completed its third series carried out at 149 participating institutions. In this third series, the case records of 4,931 lung cancer patients were submitted for analysis. A clinical staging system of these findings was then set up, arranged in the TNM classification. As a result of this work, some improvements were made in the staging system. And JCC will now propose these changes, given as follows, to UICC for consideration: Occult Cancer: TX N0 M0 Stage I: T1 N0 M0, T2 N0 M0 Stage II: T0 N1 M0, T1 N1 M0, T2 N1 M0 Stage III: T3 N0 M0, T3 N1 M0, Any T N2 M0 Stage IV: Any T, Any N M1 The factors influencing the prognosis of patients with lung cancer (Yoshimura et al., 1982 (b)) (which include age, sex, histological type, modality of treatment and type of clinical staging used) were then re-evaluated. The results of this evaluation suggest an improved 5-year survival rate when using multi-modality treatment.

Aged↗

Classification of human senile cataractous change by the American Cooperative Cataract Research Group (CCRG) method: II. Staged simplification of cataract classification.

One thousand nine hundred and seventy-six cataracts extracted intracapsularly were classified according to the system adopted by the Cooperative Cataract Research Group (CCRG) Consortium. A nine-stage protocol for simplifying the classification data is presented. The method of simplifying the basic CCRG classification emphasizes anatomic similarities among lenses. Simplification is indicated when small numbers of cataracts in any class provide insufficient statistical power to allow detection of scientifically or clinically important differences in rates between comparison groups, if such differences exist; however, simplification unavoidably obscures the anatomic, biochemical, and biophysical features of individual cataracts. Age-specific characteristics of this population of 1976 cataracts are used to demonstrate the effects of the simplification process. The preponderance of mixed cataracts and the relative scarcity of pure cataracts are documented, and the implications of these numbers for cataract research are presented.

Age Factors↗

Evaluation of single-cell classification schemes for computer classification of cervical cells.

Three single-cell classification schemes were evaluated and compared with the performance of a cytotechnologist in classifying single cells from routinely prepared cervical smears. All of the single-cell classification schemes were found to approach the performance of the cytotechnologist in distinguishing normal squamous cells from significantly dysplastic or malignant squamous cells. For distinguishing non-squamous cell types from dysplastic or malignant squamous cells, however, all three schemes fell far short of the cytotechnologist's performance in classifying the same cells. Current research aimed at overcoming these difficulties is also described.

Carcinoma in Situ↗

[A radiographic classification for sarcoidosis based on the ILP/UC classification bacillus].

A scheme was devised for semiquantitative description of 79 cases with sarcoidosis using the graphic terminology of International Labour Office and Union International Contre Le Cancer (ILO/CU) for the pneumoconioses. Among 56 patients with stage II, "linear-irregular" categories s t u (50%) and "reticulonodular" categories x y z (28%) predominated while "rounded" categories p q r (22%) were unusual. Among 13 patients with stage III s t u and x y z opacities were found in 38% of patients while p q r only in 23%. The opacities in both stages of sarcoidosis were most severe in the bilateral lower lobes. It was concluded that the traditional method for classification of sarcoidosis was helpful to give the qualitative diagnosis of the disease, but it did not provide objective description of the type and degree of pulmonary involvement. ILO/UC classification was an important supplement of traditional method as ILO/UC could be used to grade the type (linear irregular, rounded and reticulonodular opacities), severity and location of opacities. Therefore, the two methods should be used in combination so as to judge the location, type and severity of intrathoricic sarcoidosis.

Adult↗

Classification of T-cell and NK-cell neoplasms based on the REAL classification.

Mature or peripheral T-cell lymphomas are uncommon, accounting for only 10%-15% of all non-Hodgkin's lymphomas. The classification of these neoplasms has been controversial. In contrast to B-cell lymphomas, cytologic grade has not been very useful in predicting the clinical course. This finding may result from the generally aggressive clinical course associated with T-cell lymphomas. Prior studies have suggested that stage of disease may be more important than cytologic subtype. Clinical presentation is very important in the classification of T-cell malignancies. For T-cell lymphomas, cytologic features alone are not sufficient to distinguish among disease entities. For example, adult T-cell leukemia/lymphoma (ATLL) often cannot be distinguished morphologically from HTLV-1-negative T-cell lymphomas. Most extranodal T-cell lymphomas appear to be derived from cytotoxic T cells, which express perforin, TIA-1, and granzyme B. Three broad groups of T-cell malignancies can be identified: (1) leukemic or systemic disease; (2) nodal disease; (3) extranodal disease. Anaplastic large-cell lymphoma (ALCL) is probably the single most common subtype of T-cell lymphoma. Classical ALCL should be distinguished from primary cutaneous ALCL (CD30+ lymphoproliferative disease of the skin), which is a distinct disease entity.

Humans↗

[Endocrine ophthalmopathy. Clinical symptoms, classification, diagnostic classification, indications for treatment (author's transl)].

The clinical aspects and classification of "endocrine ophthalmopathy" were described. The clinical picture is of importance for the physician in nuclear medicine who is involved with the diagnosis and therapy of hyperthyroidism. In vivo and in vitro investigations in nuclear medicine regarding the classification of ophthalmic findings are derived from disturbances in control of the regulatory systems of the hypothalmas-pituitary-thyroid which are parallel to the ophthalmic processes. The clinical forms of endocrine ophthalmopathy and the thyroid findings which accompany it were systematized and an appropriate therapeutic procedure for the respective anomaly was described.

Graves Disease↗

Disease classification: measuring the effect of the Tenth Revision of the International Classification of Diseases on cause-of-death data in the United States.

The purpose of this paper is to describe the statistical impact of the Tenth Revision of the International Classification of Diseases (ICD-10) on cause-of-death data for the United States. ICD-10 was implemented in the U.S. effective with deaths occurring in 1999. The paper is based on cause-of-death information from a large sample of 1996 death certificates filed in the 50 States and the District of Columbia. Cause-of-death information in the sample includes underlying cause of death classified by both ICD-9 and ICD-10. Preliminary comparability ratios by cause of death presented in this paper indicate the extent of discontinuities in cause-of-death trends from 1998 to 1999 resulting from implementing ICD-10. For some leading causes (for example, septicaemia, influenza and pneumonia, Alzheimer's disease, and nephritis, nephrotic syndrome and nephrosis) the discontinuity in trend is substantial. Results of this study, although preliminary, are essential to analysing trends in mortality statistics between ICD-9 and ICD-10. In particular, the results provide a means for interpreting changes between 1998, which is the last year in which ICD-9 was used, and 1999, the year in which ICD-10 was implemented for mortality in the United States. Published in 2003 by John Wiley & Sons, Ltd.

Cause of Death↗

Classification of mosquitoes in tribe Aedini (Diptera: Culicidae): Paraphylyphobia, and classification versus cladistic analysis.

Many mosquito species are important vectors of human and animal diseases, and others are important nuisance species. To facilitate communication and information exchange among professional groups interested in vector-borne diseases, it is essential that a stable nomenclature be maintained. For the Culicidae, easily identifiable genera based on morphology are an asset. Major changes in generic concept, the elevation of 32 subgenera within Aedes to generic status, and changes in hundreds of species names proposed in a recent article demand consideration by all parties interested in mosquito-borne diseases. The entire approach to Aedini systematics of these authors was flawed by an inordinate fear of paraphyletic taxa or Paraphylyphobia, and their inability to distinguish between classification and cladistic analysis. Taxonomists should refrain from making taxonomic changes based on preliminary data, and they should be very selective in assigning generic names to only the most important and well-defined groups of species.

Aedes↗

Definitions and classification of tic disorders. The Tourette Syndrome Classification Study Group.

Tics are brief movements (motor tics) or sounds (vocal tics) that occur intermittently and unpredictably out of a background of normal motor activity. Although tics can appear as the result of direct brain injury (so-called symptomatic, eg, from head trauma or encephalitis), they most commonly are idiopathic and are part of the spectrum of Gilles de la Tourette syndrome or other idiopathic tic disorders. To aid investigators searching for the gene(s) causing Tourette syndrome, criteria are proposed to classify the idiopathic tic disorders. Although some of these separate entities may ultimately be shown to be caused by the same gene, until that is established, it is considered best when searching for the Tourette's gene to have tic disorders classified into distinct, homogeneous entities. The proposed classification will likely change over time as better diagnostic techniques become available and can both expand and consolidate, particularly after the Tourette gene is located.

Humans↗

The classification of depressive disorders. II. A review of historical and physiological classification studies.

A review of recent classification studies of depressive disorders based on historical data and physiological indices was made. It was found that historical variables, such as age of onset and family background, are potentially useful to distinguish depressive subgroups, although these groupings did not differentiate consistently unipolar from bipolar depressives. While the physiological indices do not support the present psychiatric nosology, single physical signs were found to differentiate subgroups within the effective disorders. The implications of these findings for a different research model were discussed.

Adjustment Disorders↗

FocalPoint slide classification algorithms show robust performance in classification of high-grade lesions on SurePath liquid-based cervical cytology slides.

The FocalPoint Primary Screening System (FPPS) operates by assigning scores to each slide relative to the probability that an abnormality is present. This information ranks each slide within five "quintiles" (1 = highest risk, 5 = lowest risk) of the "review" population, allowing examining cytologists to understand the risk inherent in each slide. Such information helps to make the primary and quality control rescreening processes most efficient. This study examines the efficiency of AutoPap scoring and, thus, stratification of high-grade cases within a clinical trial setting. A total of 1,275 SurePath (TriPath, Burlington, NC) slides were screened on the FPPS. There were 124 high-grade cases in the set (32 HSIL, 5 AIS, and 87 cancers) as determined by cytologic truth adjudication. The efficiency of FPPS ranking was determined by analysis of the numbers of high-grade cases ranked into quintiles 1 (top 20%) and 1+2 (top 40%). FPPS places cases scored as "unsatisfactory" (HSIL, 3; Cancer, 18) into quintile 5 to ensure a manual review. These cases were excluded from the analysis. Overall, 58% of high-grade slides were classified as Q1 and 83% were classified as Q1+Q2. For HSIL, 66% were classified as Q1 and 90% as Q1+Q2. For Cancer, 59% were classified as Q1 and 84% as Q1+Q2. No high-grade slides were ranked in the lower "no review" population (slides that would receive no manual examination). The results confirm the robust performance of the FPPS classification algorithm. Far more high-grade slides are classified into the top two quintiles than would be expected by random chance alone (20% and 40%, respectively). These results validate the safety and effectiveness of this device on SurePath liquid-based slides.

Algorithms↗

Artifactually induced VEP classification of form and color attributes: a refutation of "Neuroelectric concepts: form-color classification" by William J. Hudspeth (1993)

An algebraic analysis of the procedures used in "Neuroelectric Concepts: Form-Color Classification," Brain and Cognition, 21, 226-246 (1993) by William J. Hudspeth reveals that the article's results are artifactual, having been produced by the introduction of strong linear dependencies during data transformation. The same pattern of principal results is shown to obtain by applying Hudspeth's procedures both to arbitrarily selected EP input data having no connection to form or color discrimination, and to waveforms composed of sequences of random numbers.

Artifacts↗